Fluoxetine + CBT Cuts Pediatric Depression Relapse
(HealthDay News) — Fluoxetine plus relapse-prevention cognitive-behavioral therapy (CBT) cuts the risk of relapse in youth with major depressive disorder, according to a study published online June 17 in The American Journal of Psychiatry.
Betsy D. Kennard, PsyD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues treated 200 youths (aged 8–17 years) with major depression with fluoxetine for six weeks. Randomization to either continued medication management alone (69 patients) or continued medication management plus CBT (75 patients) for an additional six months was conducted in those with an adequate response (defined as a reduction of ≥50% on the Children's Depression Rating Scale-Revised [CDRS-R]).
The researchers found that during the 30-week continuation treatment period, time to remission did not differ significantly between treatment groups (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.87–1.82). There was a significantly lower risk of relapse among the medication management plus CBT group versus the medication management only group (HR, 0.31; 95% CI, 0.13–0.75), with an estimated probability of relapse by week 30 of 9 vs. 26.5%.
"Continuation-phase relapse-prevention CBT was effective in reducing the risk of relapse but not in accelerating time to remission in children and adolescents with major depressive disorder," the authors write.
One author disclosed financial ties to the pharmaceutical industry.